* Indicates required fields.
Falsification or misuse of records and/or misrepresentation of facts on University forms and documents, including but not limited to, application forms, data sheets, ID cards, fee receipts, may result in disciplinary action and/or cancellation of registration. See Section 2.16 of Student Rights and Responsibilities: A Code of Student Behavior.
Official transcripts of high school or GED scores and all post high school education
must be submitted to the Office of Admission, 8600 University Boulevard, Evansville,
List present or most recent employment first.
List community organizations, board memberships, offices held, and professional
activities that serve the community. Include activities during the last three years.
Additional community activities can be added here. (Maximum of 3000 characters.)
USI works to maintain a safe environment for all members of the University community.
The following questions will help us better maintain this environment.
If your answer is "Yes" to any of these questions, you will be asked to
provide additional information. Being convicted of a crime, pending criminal charges,
probation, suspension, dismissal or expulsion do not serve as an absolute bar to
admission, but will require additional evaluation.
By signing below I am verifying that all the above information is true and accurate
to the best of my knowledge. I also authorize the Admission Committee to review and
verify my application and academic records.
Please return this application to:
Respiratory Therapy Program
University of Southern Indiana
College of Nursing and Health Professions
8600 University Boulevard, HP 2068
Evansville, IN 47712
All application materials must be received by the University of Southern Indiana
before an admission decision can be made.
It is the policy of the University of Southern Indiana to be in full compliance with all federal and state non-discrimination and equal opportunity laws, orders and regulations relating to race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity, or veteran status. Questions or concerns should be directed to the Affirmative Action Officer, USI Human Resources Department, University of Southern Indiana, 8600 University Boulevard, Evansville, Indiana 47712.